BibTex format
@article{Stefanini:2025:10.2147/JHC.S462701,
author = {Stefanini, B and Fulgenzi, C and Scheiner, B and Korolewicz, J and Cheon, J and Nishida, N and Ang, C and Marron, T and Wu, L and Saeed, A and Wietharn, B and Rimassa, L and Pirozzi, A and Cammarota, A and Pressiani, T and Pinter, M and Balcar, L and Huang, Y and Mehan, A and Phen, S and Vivaldi, C and Salani, F and Masi, G and Bettinger, D and Vogel, A and Shoenlein, M and Von, Felden J and Shulze, K and Wege, H and Samson, A and Galle, P and Kudo, M and Manfredi, G and Celsa, C and Awosika, N and Cortellini, A and Singal, A and Sharma, R and Chon, H and Tovoli, F and Piscaglia, F and Pinato, D and D'Alessio, A},
doi = {10.2147/JHC.S462701},
journal = {Journal of Hepatocellular Carcinoma},
pages = {671--683},
title = {ALBI grade enables risk stratification for bleeding events and refines prognostic prediction in advanced HCC following atezolizumab and bevacizumab},
url = {http://dx.doi.org/10.2147/JHC.S462701},
volume = {2025},
year = {2025}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Background and Aims: Atezolizumab and bevacizumab (A+B) are recommended for treating unresectable hepatocellular carcinoma (HCC). Although highly effective, A+B can lead to potentially life-threatening adverse events including bleeding. We investigated whether albumin-bilirubin (ALBI) grade identifies patients with a higher risk of bleeding and its impact on prognosis than the Child-Pugh (CP) score.Methods: We performed a multicenter retrospective study of 15 tertiary referral centers that consecutively treated patients with A+B. We analyzed the association between the ALBI grade and gastrointestinal bleeding using the χ 2 test. Overall survival (OS) stratified by ALBI was estimated using the Kaplan-Meier method and the predictive value for the 6-months OS landmark with ROC curves.Results: Of the 368 patients included in the analysis, 163 (44.3%), 192 (52.2%) and 13 (3.5%) had ALBI 1, ALBI 2, and ALBI 3, respectively. ALBI grade was associated with a 3-fold increase in bleeding risk (3.1% in ALBI 1 vs 10.2% in ALBI 2/3, p=0.008). Among 192 patients with pre-treatment EGD, G2 and G3 varices were associated with an increased risk of bleeding, whereas G1 varices had a similar risk as no varices. Patients with ALBI 1 achieved a longer median OS (not reached; 95% CI, 24.9– 33.7), than ALBI 2 (9.7 months; 95% CI, 7.0– 12.3) or ALBI 3 (5.6 months; 95% CI, 0.1– 12.0). ALBI outperformed the CP score for predicting 6-month OS with an AUC 0.79 of ALBI versus 0.71 for the CP score (p=0.01).Conclusion: A Higher ALBI grade was associated with an increased risk of gastrointestinal bleeding after receiving A+B, and outperformed the CP score in predicting worse survival.
AU - Stefanini,B
AU - Fulgenzi,C
AU - Scheiner,B
AU - Korolewicz,J
AU - Cheon,J
AU - Nishida,N
AU - Ang,C
AU - Marron,T
AU - Wu,L
AU - Saeed,A
AU - Wietharn,B
AU - Rimassa,L
AU - Pirozzi,A
AU - Cammarota,A
AU - Pressiani,T
AU - Pinter,M
AU - Balcar,L
AU - Huang,Y
AU - Mehan,A
AU - Phen,S
AU - Vivaldi,C
AU - Salani,F
AU - Masi,G
AU - Bettinger,D
AU - Vogel,A
AU - Shoenlein,M
AU - Von,Felden J
AU - Shulze,K
AU - Wege,H
AU - Samson,A
AU - Galle,P
AU - Kudo,M
AU - Manfredi,G
AU - Celsa,C
AU - Awosika,N
AU - Cortellini,A
AU - Singal,A
AU - Sharma,R
AU - Chon,H
AU - Tovoli,F
AU - Piscaglia,F
AU - Pinato,D
AU - D'Alessio,A
DO - 10.2147/JHC.S462701
EP - 683
PY - 2025///
SN - 2253-5969
SP - 671
TI - ALBI grade enables risk stratification for bleeding events and refines prognostic prediction in advanced HCC following atezolizumab and bevacizumab
T2 - Journal of Hepatocellular Carcinoma
UR - http://dx.doi.org/10.2147/JHC.S462701
VL - 2025
ER -